The Guardian; Pharmaceutical companies should be given cash incentives of up to $3bn to find and develop new antibiotics desperately needed to keep infections at bay, according to a UK government review. Jim O’Neill, the economist and former chair of Goldman Sachs Asset Management, asked to find solutions to the global antibiotic crisis, said at the launch of his report that a fund worth between $16bn and $37bn per decade would be enough to incentivise drug companies to turn their attentions to antibiotics.

The Antimicrobial Review (AMR) Committee proposals, he said, could “supercharge antibiotics discovery, potentially saving millions of lives for a fraction of the $100tn cost of inaction”. He estimated that globally, 10 million people could die every year from untreatable infections unless new antibiotics are discovered.

O’Neill, who was asked to chair the review by David Cameron, said it was possible that the global taxpayer would have to foot the bill for the fund. “I’d say, averaged out over 7.2 billion people, it is not that much compared to one million people dying a year in China or India in 2050.”

He wants to raise the finance issue at the G20, because the empty pipeline for antibiotics is a matter of great importance for every country. But, he said, the pharmaceutical industry itself might be persuaded to contribute. “I find myself thinking of the phrase ‘enlightened self-interest’ quite a lot,” he said.

If millions start to die around the world for want of effective antibiotics – a lack that not only makes infectious diseases more deadly, but can render surgery highly dangerous – the pharmaceutical industry may find itself with the same sort of reputational damage as the financial sector, argued O’Neill. “If the leaders of top financial firms might have thought a little more broadly, they might not be under the same degree of cosh as they are today,” he said.

Companies would be rewarded with something in the region of $2bn to $3bn if they successfully launched a new antibiotic, as long as they did not seek to sell the drug at a profit. It would be sold on a not-for-profit basis, or made by a generic company with low overheads at a cheap price instead, as happens in developing countries with drugs for HIV. The global market for antibiotics is currently worth around $40bn a year. The prize fund would cost about 10% of that.

Few companies are now involved in antibiotic research, which has become an unprofitable field. Inventing new classes has proved hard and the conventional market will not reward their efforts. Any new drugs will have to be stored away for use as a last resort, when bacteria have become resistant and current drugs no longer have any power over infection. That has happened in multi-drug-resistant tuberculosis, for instance, and in the hospital “superbug” MRSA (methicillin-resistant Staphylococcus aureus). Mass use of a new antibiotic would inevitably lead to a waning of its power.

The review also supports the set-up of a global antimicrobial resistance innovation fund worth $2bn, to pay for blue-sky research into drugs and diagnostics. O’Neill said his review would explore the real need for diagnostic tests that could allow a GP to decide before writing the prescription whether their infection was bacterial and susceptible to antibiotics, or whether it was caused by a virus, such as flu and the cold.

O’Neill said the pharmaceutical industry was engaging with the discussion. Severin Schwan, chief executive of Roche, which makes most of its billions from cancer drugs, said: “Innovation in antibiotic R&D is critical for enabling the development of new treatments to combat the increasing global threat of antimicrobial resistance … The solution requires collaboration and action from pharmaceutical and biotech companies, academia, governments and public health organisations. Roche is committed to working with the AMR Review Committee and being a part of this solution.”

Patrick Vallance, GlaxoSmithKline’s president of pharmaceutical R&D, said that, as one of the few companies still conducting research in the area, they welcomed the report and were encouraged by the ideas it sets out to encourage investment and ensure reasonable returns.

Sir John Savill, chief executive at the Medical Research Council, said he knew antibiotic research needed a shot in the arm. “More money will help to move AMR research from the Cinderella status it’s currently in, to the top of the global agenda. Jim O’Neill’s report echoes our view that this needs a cross-academia, cross- industry, and cross-continent approach,” he said.

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